Tag: FluMist

Vaccines – Year in Review 2018

Another year has passed and although anti-vaccine folks keep talking about those 300 vaccines in pipeline, there were few new developments in the vaccine world in 2018.

Bob Sears got in trouble with the Medical Board of California over vaccine exemptions.
This happened in 2018.

Well, maybe that’s not entirely true.

Vaccines – Year in Review 2018

So what can we say about 2018 when it comes to vaccines?

Well, we did get some new ones!

  • approved by the FDA in late 2017, a new hepatitis B vaccine for adults, Heplisav-B, the formal recommendation for its use from the ACIP came on February 21, 2018
  • although it was both approved by the FDA and formally recommended by the ACIP in late 2017, Shingrix, the new shingles vaccine, became more widely available in 2018 – well kind of – there have been a lot of shortages due to high demand for the vaccine
  • Vaxelis, a hexavalent vaccine that combines DTaP-IPV-Hib-HepB into one shot was FDA approved on December 21, 2018, but likely won’t be available for a few more years
  • FluMist, the nasal spray flu vaccine, returned

And we lost one… Last year was the first full year that Menomune, an older meningococcal vaccine, was no longer available. It was discontinued because of low demand, as we began to use the newer vaccines, Menactra and Menveo instead.

In other immunization news:

  • a 2017 shortage of yellow fever vaccine continued into 2018
  • a shortage of monovalent pediatric hepatitis B vaccine will continue into 2019 (doesn’t affect combination vaccines with hepatitis B)
  • Gardasil 9 received an expanded recommendation – women and men between the ages of 27 and 45 years can now get vaccinated and protected with this HPV vaccine
  • the hepatitis A vaccine got a lower age recommendation – at least in special situations – “HepA vaccine be administered to infants aged 6–11 months traveling outside the United States when protection against HAV is recommended.”
  • the recommendation to use a third dose of MMR to control outbreaks of mumps was formally approved
  • the WHO updated its recommendations for use of the dengue fever vaccine (Dengvaxia) to makes sure that only dengue-seropositive persons are vaccinated, as they found an increased risk of severe dengue in seronegative people who were vaccinated
  • Of the 163 million to 168 million doses of flu vaccine that will be distributed in the United States for the 2018-2019 season, more than 80% will be thimerosal free.
  • China had an issue with substandard DTaP vaccines made by one company in one part of the country
  • India had an issue with contaminated polio vaccines made by one company in one part of the country – bivalent oral polio vaccines (two strains) still contained all three strains of polio vaccine virus
  • Measles cases and deaths spiked globally because of gaps in vaccination coverage

If you didn’t hear about any of those things in the news, you may have heard about the death of two young children in Samoa after they received an MMR vaccine. That tragedy almost certainly was caused by an error in administering/mixing the vaccines, and not because there was anything wrong with the vaccines themselves.

Need help getting educated about vaccines? Despite continued outbreaks, 2018 was a good year for vaccine advocates and vaccine education.

Several good books about vaccines were published, including:

And in case you missed it, we found out that:

Of course, for most of us, none of this is really news. We know that vaccines are safe, effective, and necessary.

And sadly, Betty Bumpers died. We can honor her legacy by continuing her work and helping to make sure that every child gets vaccinated and protected.

More on Vaccines Year in Review 2018

What Are the Side Effects of the Flu Vaccine?

Like other vaccines, flu vaccines can have side effects.

Fortunately, most of those side effects are mild.

What Are the Side Effects of the Flu Vaccine?

Not surprisingly, a lot of things that get blamed as being caused by flu vaccines are not actually side effects.

Did you actually get the flu in the days or weeks after your flu vaccine?

That’s not a side effect of your flu vaccine. Neither the inactivated flu shot, nor the attenuated FluMist can actually cause a flu infection.

Did you get a little sore at the site where you got your flu shot?

That’s a common side effect to getting a flu shot.

So is having some redness and swelling at the site, all of which begin soon after getting the shot and go away in a few days. You can also get a headache, fever, nausea, and muscle aches or signs and symptoms of an allergic reaction.

Do you have a runny nose or a cough? Side effects of the nasal spray flu vaccine can include a few days of runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough.

Again, a bad cough and cold after a flu shot isn’t a side effect of the vaccine though.

Remember, correlation does not imply causation.

If you found out you were pregnant shortly after getting a flu shot, you wouldn’t think they were associated, would you?

What about narcolepsy?

“An increased risk of narcolepsy was found following vaccination with Pandemrix, a monovalent 2009 H1N1 influenza vaccine that was used in several European countries during the H1N1 influenza pandemic.”

Narcolepsy Following Pandemrix Influenza Vaccination in Europe

Although the focus has been on the Pandemrix flu vaccine as a trigger for narcolepsy in some countries (the vaccine wasn’t used in the United States), interestingly, several countries that weren’t using the vaccine also saw a spike in narcolepsy cases as the 2009 H1N1 pandemic hit.

Doctors and pharmacies rarely give away flu shots for free. They might not charge a copay sometimes because they are getting paid by your insurance company!
Doctors and pharmacies rarely give away flu shots for free. They might not charge a copay sometimes because they are getting paid by your insurance company!

What about all of the reports of severe reactions and deaths after getting a flu shot that you might hear about? In addition to vaccine injury stories, those reports are to VAERS and typically are not causally related to getting a vaccine.

Why are there so many reports to VAERS and the NVICP about flu vaccines? Since 2006, over 1.6 trillion doses of flu vaccine have been distributed in the United States, which equals about the total of all other vaccines we use.

What Are the Side Effects of This Year’s Flu Shot

Even when folks understand that flu vaccines don’t typically cause serious side effects, the question always comes up whether or not this year’s flu shot is causing more side effects than usual.

That’s actually not unreasonable, even when you consider that the biggest change in most flu vaccines from year to year is the strain of flu viruses they include, and not any of the other ingredients.

In addition to the Pandemrix flu vaccine, in 2010, the use of one brand of flu vaccines in Australia was suspended because they were causing more side effects (fever and febrile seizures) in young children than expected.

“The studies flesh out preliminary findings from CSL in June 2012, which said that the manufacturing process retained more virus component than that of other manufacturers and that the 2010 virus components triggered an excessive immune response in some young kids.”

CSL studies shed light on 2010 flu vaccine seizures

So are there any more side effects this year?

No, there is no evidence of increased side effects from this year’s flu vaccines

More on Flu Vaccine Side Effects

I’m Not Anti-Vaccine, I Just Don’t Believe in Flu Shots

Do you know any of these folks?

“I’m not anti-vaccine, I just don’t believe in flu shots.”

They likely get all other available vaccines for themselves and their kids, but for some reason, they skip the flu shot each year.

I’m Not Anti-Vaccine, I Just Don’t Believe in Flu Shots

Are they just anti-flu vaccine? Is that a thing?

Gloria Copeland told her followers that they didn’t need flu vaccinations because Jesus already “redeemed us from the curse of the flu.”
Gloria Copeland told her followers that they didn’t need flu vaccinations because Jesus already “redeemed us from the curse of the flu.”

Why don’t they “believe” in flu shots?

Typical answers you might get, if you ask, include:

  • I never get the flu – since about 5 to 20% of people get the flu each year, it is certainly possible that you never get the flu, especially if you aren’t around many other people that could spread the flu virus to you. But unless you live and work in a bubble, there is a good chance that you will eventually be exposed to someone with the flu, might catch the flu yourself, and will spread it to someone else.
  • I only get sick when I get a flu shot – flu shots are inactivated and can’t actually give you the flu. Even the live virus nasal mist flu vaccine won’t cause you to have the flu. While flu vaccines can cause mild flu side effects, if you get sick after after a flu shot, it could be that you have another respiratory virus, your flu vaccine didn’t have time to work, or that it wasn’t effective.
  • I don’t need a flu shot – you do, if you want to reduce  your chances of getting the flu and having serious complications from a flu infection, which can affect anyone.
  • I got a flu shot last year – you need a flu vaccine each year
  • Flu vaccines don’t work – flu vaccines aren’t perfect, but they can reduce your risk of catching the flu and avoiding serious complications, even if you do get sick.
  • Flu shots are too expensive – most insurance plans cover the costs of flu vaccines, but  if you don’t have insurance, it is sometimes possible to find free flu shots at a local health clinic, or you could get a flu shot for $24 at Walmart with a GoodRx coupon.
  • I don’t have time to get a flu shot – do you have time to get sick with the flu? Many doctors now offer regular flu clinics that make it convenient to just come in and get a flu vaccine or if that isn’t possible, you can likely get a flu vaccine at a nearby pharmacy.
  • Someone on the Internet told me to never get a flu shot because they are poison – if you are avoiding a flu vaccine because you are worried about thimerosal, miscarriages, that they contain a vaginal spermicide, or other misinformation, then you likely aren’t just anti-flu vaccine…
  • Gloria Copeland told me I didn’t need one – Jesus didn’t give us a flu shot and doesn’t want you to die with the flu, or measles.

Stop making excuses, none of which hold water.

Get your flu vaccine, preferably before flu season starts and you start seeing flu activity in your area.

More on Being Anti-Flu Vaccine

How Long Does It Take for the Flu Vaccine to Start Working?

Flu shots work.

They aren’t perfect, but they can help prevent you from getting sick with the flu and have other benefits.

How Long Does It Take for the Flu Vaccine to Start Working?

They don’t work immediately though.

“It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection.”

Key Facts About Seasonal Flu Vaccine

That’s why you don’t want to wait until the last minute to get your flu vaccine.

I made sure to get my flu shot well before the start of flu season.
I made sure to get my flu shot well before the start of flu season.

You want some time for it to start working, so that you can be sure that you are protected.

So while some folks talk about getting a flu vaccine too early, you do want to make sure that you get it in time to get protection before flu is active in your area. Still, it is never too late to get a flu vaccine. It is better to get a flu vaccine late in the flu season than to skip it all together.

What about younger kids getting their flu vaccine for the first time and who need 2 doses? When do they start getting protection?

“The first dose “primes” the immune system; the second dose provides immune protection.”

Study Looks at Flu Vaccine Dosing in Children

Although they likely have some protection after that first dose, the best protection will begin 10 to 14 days after their second dose.

More on Flu Vaccine Protection

Three Reasons to Skip a Flu Shot This Year

We sometimes hear that folks are going to skip their yearly flu vaccine because they don’t believe in flu shots, they never get sick, or they think that flu shots don’t work or are dangerous.

Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.
Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.

Of course, none of those are good reasons.

Three Reasons to Skip a Flu Shot This Year

Flu vaccines are safe and have many benefits, even if they aren’t any where near 100% effective.

So are there any legitimate reasons to skip a flu shot?

Of course.

In fact, three very good reasons to skip a flu shot include:

  1. being younger than 6 months of age
  2. having a severe allergic reaction (e.g., anaphylaxis) after a previous dose of flu vaccine or to any component of the flu vaccine
  3. and, uh…

Actually, although folks might have many of bad excuses, there are only two good reasons to skip a flu shot…

So, infants who aren’t old enough to be vaccinated yet, and anyone who has had a life-threatening reaction to a previous dose.

Additional precautions, but not true contraindications, do including having had Guillain-Barré syndrome <6 weeks after a previous dose of influenza vaccine and having a moderate or severe acute illness with or without fever when you are planning to get vaccinated.

What about egg allergies?

Even if you have had a severe reaction to eggs, you can still get a flu shot. Just get it get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office), so that you can be supervised by a health care provider who is able to recognize and manage severe allergic reactions.

Bad Reasons to Skip a Flu Shot

Are you scared of shots? Flumist is back.

Are you skipping the flu shot because you never get sick? How lucky do you feel this year? Don’t continue to gamble that you won’t get the flu. Increase your chances of staying well by getting a flu shot, the best way to avoid the flu.

There aren’t any natural alternatives that work better, no matter how hard you want to believe that going to a chiropractor, using essential oils, or homeopathic remedies might be helpful.

The flu vaccine doesn’t weaken your immune system.

There are no hidden or harmful ingredients in flu vaccines.

The flu vaccine is not going to give you the flu.

And the flu is definitely not a mild disease! There were 176 pediatric flu deaths last flu season, and as in most years, most were unvaccinated.

Don’t wait. Get your flu shot.

More on Flu Vaccine Contraindications

Why Do You Need to Get a Flu Vaccine Each Year?

A yearly flu vaccine is the best way to protect yourself and your family against the flu.

But why do you need to get a flu vaccine each and every year?

Why Do You Need to Get a Flu Vaccine Each Year?

Hopefully we will one day have a universal flu vaccine that covers all flu strains and offers longer lasting protection.

Most folks know we don’t have that flu vaccine yet…

“A flu vaccine is needed every season for two reasons. First, the body’s immune response from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the formulation of the flu vaccine is reviewed each year and updated as needed to keep up with changing flu viruses. For the best protection, everyone 6 months and older should get vaccinated annually.”

CDC on Key Facts About Seasonal Flu Vaccine

So because the protection from the flu vaccine wanes or wears off relatively quickly, even if the flu vaccine strains don’t change from one year to the next, you should get a new flu vaccine.

How long does the protection from the flu vaccine last?

“An analysis from the 2011–12 through 2013–14 seasons noted protection ranging from 54% to 67% during days 0 through 180 postvaccination.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

The flu vaccines takes about two weeks to become effective and should then last for at least six months – long enough to get  you through the average flu season.

“A number of observational studies and a post hoc analysis from a randomized controlled trial have reported decreases in vaccine effectiveness (VE) within a single influenza season, with increasing time postvaccination. Waning effects have not been observed consistently across age groups, virus subtypes, and seasons; and observed declines in protection could be at least in part attributable to bias, unmeasured confounding, or the late season emergence of antigenic drift variants that are less well-matched to the vaccine strain. Some studies suggest this occurs to a greater degree with A(H3N2) viruses than with A(H1N1) or B viruses . This effect might also vary with recipient age; in some studies waning was more pronounced among older adults and younger children. Rates of decline in VE have also varied.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

That means it should last past the peak of the average flu season, which is typically between December and March.

And in most young, healthy people, the protection likely lasts even longer.

Make sure you are vaccinated well before flu season starts.
Make sure you are vaccinated well before flu season peaks, which since 1982 has occurred as early as October and as late as March, but is most common in February.

Still, there is some concern that the protection from the flu vaccine can wear off during a flu season, especially if you are very young, very old, or have chronic medical problems, and you get your flu vaccine early and you get exposed late – in April or May.

Of course, that’s not a good reason to delay getting a flu vaccine though, as waiting too long might leave you unprotected if flu peaks early, in October or November.

What to Know About Why You Need the Flu Vaccine Every Year

Since the flu vaccine strains can change and protection doesn’t last from season to season, get a flu vaccine each year. It’s the best way to protect yourself and your family against the flu.

More on Why You Need the Flu Vaccine Every Year

How Many Doses of Flu Vaccines Do My Kids Need?

One dose or two?

How many doses of flu vaccine will your kids need this year?
How many doses of flu vaccine will your kids under age 9 years need this year?

That’s right, some kids actually need two doses of the flu vaccine to get the best protection – a priming dose and a booster dose.

How Many Doses of Flu Vaccines Do My Kids Need?

You child might need two doses of flu vaccine, separated by at least 4 weeks, if they are 8 years old or younger and:

  1. this is the first year that they are getting a flu vaccine, or
  2. they have not received two or more total doses of flu vaccine before

That second part is a little confusing.

That’s because the two doses do not have to have been in the same season or even in consecutive seasons. As long as a child has had at least 2 or more doses of flu vaccine in the past, then they only need one dose this year.

And even if they have never had a flu vaccine before, kids who are already 9 years old, only get one dose.

“Evidence from several studies indicates that children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

Why do they get 2 doses?

“The first dose “primes” the immune system; the second dose provides immune protection.”

Study Looks at Flu Vaccine Dosing in Children

Because studies show that getting 2 doses of flu vaccine like this works best!

More on Flu Vaccine Doses for Kids